Provider Demographics
NPI:1932331824
Name:WERTH, KATHERINE J (NP-C, FNP)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:J
Last Name:WERTH
Suffix:
Gender:F
Credentials:NP-C, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7101 NEWPORT AVE STE 304
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68152-2167
Mailing Address - Country:US
Mailing Address - Phone:402-572-3684
Mailing Address - Fax:402-572-2377
Practice Address - Street 1:7101 NEWPORT AVE STE 304
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68152-2167
Practice Address - Country:US
Practice Address - Phone:402-572-3684
Practice Address - Fax:402-572-2377
Is Sole Proprietor?:No
Enumeration Date:2009-08-11
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111062363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily